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- ItemAcesso aberto (Open Access)Análise comparativa do tratamento do condiloma acuminado anal e perianal utilizando plasma de argônio e eletrofulguração em doentes HIV positivo e negativo(Universidade Federal de São Paulo (UNIFESP), 2017-07-31) Braga, Eduardo Angelo [UNIFESP]; Lopes Filho, Gaspar de Jesus [UNIFESP]; Saad, Sarhan Sydney [UNIFESP]; http://lattes.cnpq.br/8646840760424911; http://lattes.cnpq.br/3518607824692081; http://lattes.cnpq.br/2072176749270040; Universidade Federal de São Paulo (UNIFESP)Introduction: Human papillomavirus (HPV) infection is the sexually transmitted disease most frequently diagnosed in Brazil, in both men and women and its incidence has been increasing over recent years. It may occur in association with the human immunodeficiency virus (HIV) in up to 62% of the cases1,2. Despite various forms of treatment for Condylomata, relapses are frequent and both the immediate and the long-term results are unsatisfactory. Use of argon plasma is an attractive option because its results are effective. However, further studies comparing this with the standard treatment are still needed. Purpose: To compare the efficiency and complications of treatments for anal and perianal condyloma using argon plasma and electrofulguration and the recurrence rates of these treatments. Methods: From January 2013 to April 2014, in 37 cases of perianal and anal condyloma, the patients’ anal region was divided into two semicircles. Treatment with argon plasma coagulation or electrofulguration was then randomly assigned (one method for each semicircle). The therapeutic sessions were repeated until clinical signs of HPV infection had been eliminated. Tissue samples were taken for cytological, histological and PCR evaluations. Results: The HPV genotype, presence of more than one genotype per patient, oncological potential per genotype and cytological and histological results were analyzed. There was no significant difference in effectiveness between the argon and fulguration methods, based on recurrence and disease-free interval (p > 0.05). In relation to argon application, the variables studied were not associated with recurrence of condyloma (p > 0.05). However, the areas treated with electrofulguration in HIV-positive patients presented more relapses, with a significant difference (p = 0.01). Conclusion: Use of argon plasma was less influenced by presence of HIV than was use of electrofulguration. With regard to efficacy, the methods were statistically equivalent, however, the areas treated with electrofulguration in HIV-positive patients presented worse results with more relapses.
- ItemAcesso aberto (Open Access)Argon plasma versus electrofulguration in the treatment of anal and perianal condylomata acuminata in patients with acquired immunodeficiency virus(Acta Cirurgica Brasileira, 2017) Braga, Eduardo Angelo [UNIFESP]; Lopes Filho, Gaspar de Jesus [UNIFESP]; Saad, Sarhan Sydney [UNIFESP]Purpose: To compare the effectiveness of anal and perianal condylomata treatment using argon plasma and electrofulguration. Methods: From January 2013 to April 2014, 37 patients with anal and perianal condylomata, who had been diagnosed through proctological examination, oncotic cytology, polymerase chain reaction (PCR) and histology, underwent treatment with argon plasma and electrofulguration. The perianal and anal regions were divided into two semicircles. Each semicircle was treated using one of the methods by means of simple randomization. Therapeutic sessions were repeated until all clinical signs of infection by HPV were eliminated. The patients were evaluated according to several variables like the genotype of HPV, HIV infection, oncological potential per genotype, oncotic cytology and histology. Results: Among all the variables studied, only immunosuppression due to HIV influenced the results, specifically when the fulguration method was used. There was no significant difference in effectiveness between argon and fulguration based on lesion relapse (p > 0.05). However, among HIV-positive patients, fulguration presented worse results, with a significant difference (p = 0.01). Conclusion: Regarding treatment of anal and perianal condylomata acuminata, comparison between applying fulguration and argon demonstrated that these methods were equivalent, but use of fulguration presented more relapses among HIV-positive patients.
- ItemSomente MetadadadosContribuição ao estudo do material resultante do tratamento de neoplasias intra-epitelias cervicais (NIC), pelo método de cirurgia e alta frequência (CAF)(Universidade Federal de São Paulo (UNIFESP), 1999) Souza, Antonio Francisco de [UNIFESP]; Stávale, João Norberto [UNIFESP]O presente trabalho representa uma contribuição ao estudo morfológico de 683 casos de materiais de colo uterino resultantes de cirurgia de alta freqüência (CAF), comparando, quando possível, com os resultados citológicos e/ou histológicos prévios. Esse material de estudo foi obtido pela equipe do serviço de Genecologia (cirurgia ambulatorial e dos blocos cirúrgicos) dos hospitais Instituto João Resende Alves (IJRA), hoje Hospital Luxemburgo, e Hospital Mário Penna e processado no Departamento de Anatomia Patológica e Citopatologia, também desses hospitais. Os materiais resultantes das CAF foram estabilizados em fixador de rotina em anatomia patológica (formalina a 1O por cento) e seu tratamento químico realizado em Processador automático de tecidos. Todo o material cirúrgico foi processado e incluído em blocos de gl parafina, sendo confeccionadas lâminas com cortes escalonados de 5 micras, que foram submetidas à coloração pelo método de hematoxilina-eosina (HE). Os dados analisados incluíram a idade das pacientes, diagnósticos prévios citológicos e histológicos, condições macroscópicas do material resultante da CAF (se removido por excisão cônica ou se obtido por múltiplas excisões), profundidade da exérese, diagnóstico realizado, condições das margens cirúrgicas (anterior e posterior), curetagem pós-CAF do coto de colo remanescente, integridade das alterações morfológicas nas lesões estudadas, alterações tissulares promovidas pelo efeito térmico e seu grau de interferência no diagnóstico histológico.
- ItemSomente MetadadadosPiezoelectric osteotomy for the placement of titanium implants in rabbits: histomorphometry study(Wiley-Blackwell, 2014-10-01) Kfouri, Flavio de Avila [UNIFESP]; Duailibi, Monica Talarico [UNIFESP]; Bretos, José Luis Gonçalves [UNIFESP]; Carvalho, Aluizio Barbosa [UNIFESP]; Pallos, Debora; Duailibi, Silvio Eduardo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Santo AmaroObjective: To evaluate bone remodeling around dental implants inserted into recipient sites prepared using either the piezoelectric or the conventional drilling technique.Material and Methods: Twenty-four male New Zealand white rabbits (4 months, 2.70 kg) received dental implants (3.3 mm diameter and 6 mm length) on the medial surface of the tibia and were divided into 3 groups (n = 8). Group I was euthanized at 7 days; group II, at 14; and group III, at 28 days. Each animal received four implants, two in the right and two in the left tibia (96 implants were installed). Each tibia was operated by the same technique, and there are therefore neighbor's implants installed by different techniques. Histomorphometric parameters were used: the volume occupied by trabecular bone around the implants (BV/TV), media thickness, separation and number of trabeculae around the loops, and the contact area (interface) directly between the bone and implant (BIC).Results: BV/TV was similar for both techniques (P = 0.291). Reduction in trabecular thickness was observed for both techniques (P < 0.05), but then returned to prior levels, with no significant difference between techniques (P = 0.217). Trabecular number increased from day 7 to day 14 (P < 0.001) and remained constant afterward for both techniques. No difference in BIC was observed between techniques on day 28 (P = 0.961).Conclusions: Piezoelectric osteotomy allowed bone formation for osseointegration of titanium implants, was not associated with bone necrosis, and provided results similar to those of the conventional technique. the piezoelectric technique can be considered a viable alternative in dental implantology.
- ItemSomente MetadadadosRecanalização do ducto lacrimonasal com eletrocirurgia (Rádio Frequência)(Universidade Federal de São Paulo (UNIFESP), 2019-06-27) Garcia, Eduardo Alonso [UNIFESP]; Nose, Walton [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: To analyze the technique of recanalization of the lacrimal nasal duct with electrosurgery (High Frequency) for patients with chronic dacryocystitis, reestablishing the flow of the lacrimal system and comparing the electromagnetic wave modulations between cut and coagulation. Methods: Seventy-six patients with chronic dacryocystitis underwent recanalization of the nasal lacrimal duct with electrosurgery (High Frequency) followed by 60-day silicone intubation (mean). The postoperative was performed with antibiotic and corticoid drops until the silicone was removed. Results: Cases with positive irrigation (reaching the nasal cavity) 30 days after the postoperative silicone removal were considered successful. Sixty-three patients (82,9%) were successful in the procedure, and thirteen (17,1%) presented failure in the procedure with irrigation impossible and there was no statistical difference between the different wave modulations tested. Conclusion: The technique of recanalization of the nasolacrimal duct with electrosurgery (HF) was efficient for the correction of chronic dacryocystitis, restoring the natural flow of the tear without the need to perform an osteotomy followed by anastomosis of the lacrimal pathway with the nasal cavity and there was no statistically significant difference between the two wave modulation group.